益阳市基层医疗机构门诊处方行为的综合评价  

Comprehensive evaluation on the prescription behavior for outpatients in primary health care institutions of Yiyang

作　　者：任晓华[1] 黄东红[2] 夏大 史静琤[1] 

机构地区：[1]中南大学公共卫生学院流行病与卫生统计学系,长沙410078 [2]中南大学公共卫生学院社会医学与卫生事业管理学系,长沙410078 [3]益阳市卫生计生委,湖南益阳413000

出　　处：《中南大学学报（医学版）》2016年第2期182-190,共9页Journal of Central South University ：Medical Science

摘　　要：目的:分析益阳市基层医疗机构门诊处方行为及影响因素,并对其行为进行综合评价,为提高合理用药水平提供科学依据。方法:采用多阶段随机抽样的方法,随机抽取益阳市21家基层医疗机构,每家机构每月随机抽取15张处方,一年共3 780张,逐一登记处方信息,分析评价处方行为。结果:每张处方平均用药种数和注射剂处方百分率超过国际标准。未成年患者多重用药、抗生素、激素和注射剂处方使用率较高,女性患者基本药物使用率较高,夏、秋季抗生素、激素使用率较高,乡镇卫生院多重用药、抗生素、注射剂和基本药物使用率较高,皮肤和皮下组织疾病多重用药处方使用率较高,呼吸系统疾病抗生素、激素和静脉注射处方使用率较高。大部分基层医疗机构合理用药水平为中上等。结论:益阳市基层医疗机构处方合理用药水平整体较好,但仍面临每张处方平均用药品种数和注射剂处方百分率超过国际标准的双重挑战,基层医师应严格规范处方用药行为。Objective： To evaluate the prescription behavior for outpatients in primary health care institutions of Yiyang and to provide scientific basis for promoting the rational use of drugs.Methods： A multi-stage random sampling method was conducted in 21 primary health care institutions from Yiyang. Fifteen prescriptions were randomly selected in every month from each institution and a total of 3 780 prescriptions were eventually collected in a year.Results： Both the number of drugs and percentage of injection in a prescription were greater than the international standards. Children were more likely to be prescribed by multiple prescriptions,antibiotics prescriptions, hormones and injections prescriptions. The utilization of essential drug was more frequent in female. Antibiotics and hormones were more frequently used in summer and autumn season. Polypharmacy, antibiotics, injections and essential drugs were more frequently used in hospitals of small town. The skin and subcutaneous tissue diseases were often treated with multiple prescriptions, while the respiratory diseases were often treated with antibiotics,hormones and injections. Most primary health care institutions were at the upper limit of rational drug use.Conclusion： The usage of prescription drug in most primary health care is rational, but some still surpass international standards. Thus, primary health care physicians should strictly control their prescriptions behavior.

关 键 词：门诊处方 合理性 影响因素 综合评价 益阳市 

分 类 号：R95[医药卫生—药学]